Canada's Promise Unfulfilled: Indigenous Children Denied Vital Care

OTTAWA, ON – January 19, 2026 – Two of Canada’s leading healthcare associations have issued an urgent call to action, warning that First Nations and Inuit children are being systematically denied access to essential health services due to critical failures in the implementation of federal programs designed to protect them. The Canadian Association of Occupational Therapy (CAOT) and Speech-Language & Audiology Canada (SAC) are demanding the federal government address the bureaucratic barriers and unacceptable delays that plague Jordan’s Principle and the Inuit Child First Initiative (ICFI).

These programs were established as legal and moral obligations to ensure Indigenous children can access the health, social, and educational support they need without delay. Yet, according to frontline practitioners, the promise of equitable care remains unfulfilled, leaving children to suffer the consequences of a broken system.

The Human Cost of Systemic Delays

For children, the services provided by occupational therapists, speech-language pathologists, and audiologists are not optional—they are foundational to development. These services help children perform tasks many take for granted, from communicating their needs and learning in school to playing with friends and participating in family life. When access is delayed, the impact can be devastating and lifelong.

“Jordan’s Principle is not a nice-to-have. It exists to ensure First Nations children receive the care they need, where, and when they need it,” said Irving Gold, Chief Executive Officer of CAOT. “Occupational therapists help children do everyday things... When access to these essential services is delayed, children are denied care they are legally entitled to, and families are left to navigate complex systems alone.”

The consequences of these delays ripple through a child's life. A lack of speech therapy can hinder language acquisition and academic progress. Without occupational therapy, a child with a disability may struggle with basic daily activities, leading to social isolation and diminished quality of life. The press release from CAOT and SAC grimly notes that when these supports are unavailable, individuals may turn to unsafe coping mechanisms, “fueling cycles of addiction, worsening mental health, and deepening social and economic hardship.”

Luciana Nechita, CEO of SAC, emphasized the critical nature of her members' work. “Speech-language pathology and audiology services are essential health services under Jordan’s Principle and critical to children’s ability to communicate, learn, and thrive,” she stated. “Ongoing administrative barriers are delaying access to care, with real consequences for First Nations children and families.”

A Principle Under Pressure

Jordan’s Principle is a human rights principle named in memory of Jordan River Anderson, a First Nations child from Norway House Cree Nation who spent his entire life in a hospital while the federal and provincial governments argued over who should pay for his at-home care. He died in 2005 without ever having lived in his family’s home. The principle, now a legal rule affirmed by multiple Canadian Human Rights Tribunal (CHRT) orders, dictates that the government of first contact must pay for an approved service for a First Nations child and resolve jurisdictional or payment disputes later.

The Inuit Child First Initiative (ICFI) was established as a parallel program to ensure Inuit children have similar access to necessary services. However, practitioners from CAOT and SAC report that both initiatives are buckling under the weight of “long wait times, complex funding processes, and inconsistent interpretations.”

Research and government reports confirm these systemic issues. While Indigenous Services Canada (ISC) has committed nearly $10 billion to Jordan's Principle since 2016 and extended ICFI funding, the department has also acknowledged a significant backlog in processing requests. The CHRT has repeatedly ruled that Canada’s implementation has been discriminatory and that Jordan’s Principle is a legal obligation that cannot be limited by a fixed budget. Despite these rulings, the gap between the principle’s intent and its on-the-ground execution persists, particularly in northern and remote communities where access to specialized care is already scarce.

A Unified Call for Federal Accountability

The call for reform from healthcare professionals is strongly supported by Indigenous leadership. Abram Benedict, Ontario Regional Chief for the Chiefs of Ontario, joined the associations in their demand for government action.

“Every First Nations child has the right to timely, equitable access to the health care they need to live happy, healthy lives,” said Chief Benedict. “The ongoing delays and systemic barriers that plague the Jordan’s Principle system hurt children and their families. Chiefs of Ontario is calling on the federal government to take immediate and meaningful action to remove these barriers and uphold their Treaty obligations and legal and fiduciary duties.”

In response to ongoing criticism, the federal government has taken some steps. In February 2025, ISC introduced revised operating procedures intended to clarify documentation requirements and expedite decision-making for both Jordan’s Principle and the ICFI. The government is also engaged in a process with Inuit Tapiriit Kanatami and other Inuit partners to co-develop a long-term, Inuit-specific replacement for the ICFI.

However, for the thousands of practitioners represented by CAOT and SAC, these measures have not been enough to resolve the crisis. Their joint statement underscores a deep frustration that despite historic funding announcements and policy adjustments, children are still being left behind. The core problem, they argue, remains the administrative maze that stands between a child in need and the care they are legally and morally owed.

As these advocacy groups and Indigenous leaders intensify their pressure, the federal government faces renewed scrutiny over its commitment to substantive equality. The challenge is not merely to allocate funds but to dismantle the bureaucratic structures that continue to perpetuate the very discrimination Jordan’s Principle was created to eliminate. For thousands of children, the gap between the government's promise and the reality of their daily lives remains a chasm that determines their future.